Purpose: Implant subsidence is a possible complication of spinal interbody fusion. We aim to evaluate porous titanium cages subsidence, fusion and functional outcomes in patients subjected to oblique lumbar interbody ...Purpose: Implant subsidence is a possible complication of spinal interbody fusion. We aim to evaluate porous titanium cages subsidence, fusion and functional outcomes in patients subjected to oblique lumbar interbody fusion (OLIF) with these novel devices. Methods: Our institutional review board approved a single-center experience which included 60 patients who underwent OLIF from June 2018 to June 2020 utilizing the porous titanium implants. Data was collected in accordance with the Declaration of Helsinki, and written informed consent was obtained. Imaging studies including radiographs 1, 3, 6 and 12 months and computed tomography (CT) scan at 6 months obtained during routine postoperative follow-up visits, were studied for signs of implant subsidence, fusion and clinical parameters to determine the effectiveness of surgery such as Oswestry disability index (ODI). Results: Radiographic subsidence occurred in 1 out of 89 porous titanium interbody cages (1.1%). No subsidence was observed in the posterior screws and rods fixation group (N = 57). However, one case of subsidence occurred in the lateral plate fixation group (N = 3). The subsidence occurred in an osteoporotic elderly patient operated for adjacent segment disease, and she was later revised with posterior instrumentation using cemented screws and rods. She had an uneventful recovery. Fusion rates were evaluated under CT scan at 6 months with a rate of 88%. In terms of clinical outcomes, ODI decreased significantly from 20.3 preop to 10.7 postop with a P-value Conclusions: In our study, the subsidence rate was lower than previously reported in the literature. Also, we had good fusion rates at 6 months likely due to the porous titanium cages use. We had no subsidence in the posterior instrumented group and one case in the lateral fixation group with improved clinical outcomes.展开更多
目的本研究通过分析膝骨关节炎(knee osteoarthritis,KOA)患者西安大略和麦克马斯特大学(the Western Ontario and McMaster universities,WOMAC)关节炎指数与冠状位下肢力线角度及腰椎生物力学因素的相关性,为临床诊治KOA提供新思路。...目的本研究通过分析膝骨关节炎(knee osteoarthritis,KOA)患者西安大略和麦克马斯特大学(the Western Ontario and McMaster universities,WOMAC)关节炎指数与冠状位下肢力线角度及腰椎生物力学因素的相关性,为临床诊治KOA提供新思路。方法选自2022年10月至2023年5月就诊于河北中医药大学第一附属医院骨伤三科门诊且符合入组标准的267例KOA患者,其中男49例,女218例;年龄50~83岁,平均(61.55±8.72)岁。拍摄腰椎联合双下肢全长正位负重位X线片,观察腰骶偏移方向,测量冠状位下肢力线角度:髋膝踝角(hip knee ankle,HKA)、机械轴偏移距离(mechanical axis deviation,MAD)、关节线相交角(joint line convergence angle,JLCA)以及腰椎生物力学因素:腰骶偏移距离(lumbosacral offset distance,LOD)、腰膝偏移距离(waist and knee offset distance,WKOD),并对受试者进行WOMAC评分及基线资料记录,分析其与冠状位力线角度及腰椎生物力学因素的相关性。结果腰骶偏移方向与KOA疼痛严重侧存在相关性(P<0.05,r=0.569),LOD、WKOD、HKA、MAD、JLCA、病程与WOMAC评分均存在相关性(P<0.05,r值分别为:0.585、0.579、-0.156、0.173、0.175、0.189)。结论KOA患者关节疼痛、功能受限与腰椎重心的偏移及下肢力线角度存在相关性,KOA患者关节僵硬程度与病程存在相关性,其腰椎冠状位重心偏移是诱发或加重KOA的危险因素之一。展开更多
文摘Purpose: Implant subsidence is a possible complication of spinal interbody fusion. We aim to evaluate porous titanium cages subsidence, fusion and functional outcomes in patients subjected to oblique lumbar interbody fusion (OLIF) with these novel devices. Methods: Our institutional review board approved a single-center experience which included 60 patients who underwent OLIF from June 2018 to June 2020 utilizing the porous titanium implants. Data was collected in accordance with the Declaration of Helsinki, and written informed consent was obtained. Imaging studies including radiographs 1, 3, 6 and 12 months and computed tomography (CT) scan at 6 months obtained during routine postoperative follow-up visits, were studied for signs of implant subsidence, fusion and clinical parameters to determine the effectiveness of surgery such as Oswestry disability index (ODI). Results: Radiographic subsidence occurred in 1 out of 89 porous titanium interbody cages (1.1%). No subsidence was observed in the posterior screws and rods fixation group (N = 57). However, one case of subsidence occurred in the lateral plate fixation group (N = 3). The subsidence occurred in an osteoporotic elderly patient operated for adjacent segment disease, and she was later revised with posterior instrumentation using cemented screws and rods. She had an uneventful recovery. Fusion rates were evaluated under CT scan at 6 months with a rate of 88%. In terms of clinical outcomes, ODI decreased significantly from 20.3 preop to 10.7 postop with a P-value Conclusions: In our study, the subsidence rate was lower than previously reported in the literature. Also, we had good fusion rates at 6 months likely due to the porous titanium cages use. We had no subsidence in the posterior instrumented group and one case in the lateral fixation group with improved clinical outcomes.
文摘目的本研究通过分析膝骨关节炎(knee osteoarthritis,KOA)患者西安大略和麦克马斯特大学(the Western Ontario and McMaster universities,WOMAC)关节炎指数与冠状位下肢力线角度及腰椎生物力学因素的相关性,为临床诊治KOA提供新思路。方法选自2022年10月至2023年5月就诊于河北中医药大学第一附属医院骨伤三科门诊且符合入组标准的267例KOA患者,其中男49例,女218例;年龄50~83岁,平均(61.55±8.72)岁。拍摄腰椎联合双下肢全长正位负重位X线片,观察腰骶偏移方向,测量冠状位下肢力线角度:髋膝踝角(hip knee ankle,HKA)、机械轴偏移距离(mechanical axis deviation,MAD)、关节线相交角(joint line convergence angle,JLCA)以及腰椎生物力学因素:腰骶偏移距离(lumbosacral offset distance,LOD)、腰膝偏移距离(waist and knee offset distance,WKOD),并对受试者进行WOMAC评分及基线资料记录,分析其与冠状位力线角度及腰椎生物力学因素的相关性。结果腰骶偏移方向与KOA疼痛严重侧存在相关性(P<0.05,r=0.569),LOD、WKOD、HKA、MAD、JLCA、病程与WOMAC评分均存在相关性(P<0.05,r值分别为:0.585、0.579、-0.156、0.173、0.175、0.189)。结论KOA患者关节疼痛、功能受限与腰椎重心的偏移及下肢力线角度存在相关性,KOA患者关节僵硬程度与病程存在相关性,其腰椎冠状位重心偏移是诱发或加重KOA的危险因素之一。
文摘目的在北京市人群中开展骨退行性疾病(bone degenerative diseases,BDD)研究,以了解北京市BDD人群患病情况及影响因素。方法采用方便抽样,招募自愿参与且年龄在18~<65岁的北京市常住人群进入北京BDD研究。采用问卷收集受试者的一般人口学资料,同时对受试者进行体格检查、生化检查和骨科专科体检,并开展影像学检查。运用多因素logistic回归模型分析BDD影响因素。结果共纳入879名研究对象,年龄为(39.79±9.12)岁。共有697人患有BDD,占总人数79.29%。多因素logistic回归模型分析显示,高龄人群患BDD的风险较高。与18~<35岁组相比,35~<50岁组与50~<65岁组BDD患病的OR值(95%CI)分别为2.684(1.845~3.904)与13.898(4.807~40.176)。超重和肥胖者与体质指数(body mass index,BMI)正常者相比,OR值(95%CI)分别为1.209(0.811~1.801)和1.768(1.030~3.035)。已婚者患病风险显著高于未婚/离异/丧偶者,其OR值(95%CI)为1.924(1.271~2.912)。结论北京市18~<65岁人群BDD检出率较高。应加强在已婚、高年龄段、超重和肥胖者中BDD的宣传及体检。
